002-aircraft-data-sheet

gaca_gov_sa · form · processed · 2 chunks
document_type=form entity=format:application/pdf entity=language:ar language=en taxonomy_l1=transport taxonomy_l2=aviation taxonomy_l3=aircraft_certification validity=valid validity_confidence=0.6
GACA
العربيه العامه للطيران المدني
General Authority of Civil Aviation
AIRCRAFT DATA SHEET
Note:
1. All Certificates, AD's and life limited equipment installed on the aircraft will have a minimum calendar life of 90 days remaining, prior to expiry from the date of application submitted to the GACA, otherwise all applications will be rejected and returned to the applicant for resubmission.
2. Any changes/corrections to this form after signature/stamp by the NCAA of Aircraft Registry will null and void the form.
3. Original copy of this form should be submitted to GACA with application.
A. Aircraft Information
<table><tr><td colspan="4">Registration Mark</td><td>Serial No.</td><td colspan="3"></td><td colspan="2">Type Cert. No.</td><td></td></tr><tr><td colspan="4">Max. Gross Weight (kg)</td><td>TT (hours)</td><td colspan="3"></td><td colspan="2">TC (Cycles)</td><td></td></tr><tr><td colspan="4">Aircraft Manufacturer</td><td>Model/Series</td><td colspan="3"></td><td colspan="2">Date of Mfr.</td><td></td></tr><tr><td colspan="4">Engine Manufacturer</td><td colspan="7">Model/Series</td></tr><tr><td>Serial No.</td><td>1</td><td colspan="2"></td><td>2</td><td></td><td>3</td><td colspan="2"></td><td>4</td><td></td></tr><tr><td colspan="3">Propeller Manufacturer</td><td colspan="2"></td><td colspan="2">Model/Series</td><td colspan="4"></td></tr><tr><td>Serial No.</td><td>1</td><td colspan="2"></td><td>2</td><td></td><td>3</td><td colspan="2"></td><td>4</td><td rowspan="2"></td></tr><tr><td colspan="6">APU Manufacturer</td><td colspan="4">Model/Series</td></tr></table>
B. Last Airworthiness Directives (AD) or Bi-Weekly AD Complied with:
<table><tr><td>FAA</td><td>No.</td><td>Date</td><td>EASA</td><td>No.</td><td>Date</td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td></tr></table>
C. Approved Programs / Manuals:
<table><tr><td>#</td><td>Type</td><td>Revision No.</td><td>Revision Date</td></tr><tr><td>1</td><td>Airplane Flight/Operating Manual (AFM/AOM)</td><td></td><td></td></tr><tr><td>2</td><td>Approved Aircraft Inspection Program GACAR 91.449</td><td></td><td></td></tr><tr><td>3</td><td>Master/Minimum Equipment List (MMEL/MEL)</td><td></td><td></td></tr><tr><td>4</td><td>Aging Aircraft CPCP</td><td></td><td></td></tr><tr><td rowspan="2">5</td><td rowspan="2">Type of Operations</td><td>□ Part 91</td><td>□ Part 121 SCH</td></tr><tr><td>□ Part 121 SPCL</td><td>□ Part 125</td></tr></table>
D. Last Aircraft Inspections Performed
<table><tr><td>#</td><td>Type</td><td>Date</td><td>Total Time</td><td>Location</td><td colspan="3">AMO/IA/ME Certificate/License No.</td></tr><tr><td>1</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>2</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr></table>
E. Equipment and Systems Status
<table><tr><td rowspan="2" colspan="2">Description</td><td rowspan="2">Number Installed</td><td colspan="4">Next Due or Expiry Date</td></tr><tr><td>Position 1</td><td>Position 2</td><td>Position 3</td><td>Position 4</td></tr><tr><td>1</td><td>ATC Transponder Test &amp; Inspection (91.453)</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>2</td><td>Altimeter System Test &amp; Inspection (91.451)</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>3</td><td>Standby Compass Swing</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>4</td><td>Emergency Locater Transmitter ELT Battery (91 App &#x27;C&#x27;)</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>5</td><td>Date of Mass (Weight) &amp; Balance last check</td><td colspan="5"></td></tr></table>
GACA-AVSES-AIR-F002
Rev: 6, Date: 13 Apr 25
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GACA
الهييه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
AIRCRAFT DATA SHEET
F. Emergency Equipment
<table><tr><td rowspan="2">#</td><td rowspan="2">Description</td><td rowspan="2">Number Installed</td><td colspan="6">Next Due or Expiry Date</td></tr><tr><td>1</td><td>2</td><td>3</td><td>4</td><td>5</td><td>6</td></tr><tr><td>1</td><td>Portable Fire Extinguisher/s</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>2</td><td>Escape Slide/s</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>3</td><td>Life Raft/s</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>4</td><td>Portable Breathing Equipment (PBE)</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>5</td><td>Portable Oxygen Cylinder/s</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>6</td><td>Automatic Electronic Defibrillator</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>7</td><td>First Aid Kit</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>8</td><td>Doctor Kit</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr></table>
G. Statement of Undertaking
<table><tr><td>Name</td><td>Position/Title*(Applicable to Large Aircraft)</td><td>Company</td></tr><tr><td></td><td>Owner/Operator</td><td rowspan="3"></td></tr><tr><td></td><td>*Director Quality Assurance</td></tr><tr><td></td><td>*Director Maintenance</td></tr><tr><td colspan="3">I do hereby certify that the above information and attached documents are true and correct and that the aircraft is in a condition for safe operation.</td></tr><tr><td>Date</td><td>Signature</td><td>Stamp</td></tr><tr><td></td><td></td><td></td></tr></table>
H. Accreditation of Data by the National Civil Aviation Authority for the State of Registry (Foreign Operator Only)
<table><tr><td>Name</td><td>Position/Title</td><td>Name of the Authority for the State of Registry</td></tr><tr><td></td><td></td><td></td></tr></table>
Address
I do hereby certify that, according to the records held by this Authority, the above information is true and correct and the operator is appropriately certified, and the aircraft holds a valid Certificate of Airworthiness.
<table><tr><td>Date</td><td>Signature</td><td>Stamp</td></tr><tr><td></td><td></td><td></td></tr></table>
GACA-AVSES-AIR-F002
Rev: 6, Date: 13 Apr 25
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